Jalayne J. Arias, Lillian Morgado, Stephanie Grace Prost
The number of older adults incarcerated in prisons is growing significantly, and there is a great need for legal authority, processes, and resources to mitigate individual and social burdens of elder neglect and abuse within these settings. Older adults in prison may be particularly vulnerable to abuse, neglect, or exploitation. They are dependent on the carceral system for basic resources, are at risk for retaliatory actions for reporting mistreatment, and bear disproportionately high health burdens. This essay first considers standards and resources for mitigating elder mistreatment in the community and residential-care settings in contrast to the available resources in prisons. Arguing that a conceptual model of elder abuse tailored to the prison population is needed, the essay proposes a research agenda through which such a model could be developed. The model could then be used in the creation of policy for detecting and mitigating elder mistreatment of incarcerated people. The essay concludes with a call to action to address the rift in legal protections and processes that leave older adults in prison at increased risk of abuse and neglect without a clear pathway for recourse.
{"title":"Forgotten and without Protections: Older Adults in Prison Settings","authors":"Jalayne J. Arias, Lillian Morgado, Stephanie Grace Prost","doi":"10.1002/hast.1540","DOIUrl":"10.1002/hast.1540","url":null,"abstract":"<p><i>The number of older adults incarcerated in prisons is growing significantly, and there is a great need for legal authority, processes, and resources to mitigate individual and social burdens of elder neglect and abuse within these settings. Older adults in prison may be particularly vulnerable to abuse, neglect, or exploitation. They are dependent on the carceral system for basic resources, are at risk for retaliatory actions for reporting mistreatment, and bear disproportionately high health burdens. This essay first considers standards and resources for mitigating elder mistreatment in the community and residential-care settings in contrast to the available resources in prisons. Arguing that a conceptual model of elder abuse tailored to the prison population is needed, the essay proposes a research agenda through which such a model could be developed. The model could then be used in the creation of policy for detecting and mitigating elder mistreatment of incarcerated people. The essay concludes with a call to action to address the rift in legal protections and processes that leave older adults in prison at increased risk of abuse and neglect without a clear pathway for recourse</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Contributors","authors":"","doi":"10.1002/hast.1546","DOIUrl":"https://doi.org/10.1002/hast.1546","url":null,"abstract":"","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139042117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lawrence O. Gostin, Kevin A. Klock, Alexandra Finch
Global health has long been characterized by injustice, with certain populations marginalized and made vulnerable by social, economic, and health disparities within and among countries. The pandemic only amplified inequalities. In response to it, the World Health Organization and the United Nations have embarked on transformative normative and financial reforms that could reimagine pandemic prevention, preparedness, and response (PPPR). These reforms include a new strategy to sustainably finance the WHO, a UN political declaration on PPPR, a fundamental revision to the International Health Regulations, and negotiation of a new, legally binding pandemic agreement (popularly called the “Pandemic Treaty”). We revisit the cavernous shortcomings of the global Covid-19 response, explain potentially transformative legal reforms and the ethical values that underpin them, and propose actionable solutions to advance both health and justice.
{"title":"Making the World Safer and Fairer in Pandemics","authors":"Lawrence O. Gostin, Kevin A. Klock, Alexandra Finch","doi":"10.1002/hast.1538","DOIUrl":"10.1002/hast.1538","url":null,"abstract":"<p><i>Global health has long been characterized by injustice, with certain populations marginalized and made vulnerable by social, economic, and health disparities within and among countries. The pandemic only amplified inequalities. In response to it, the World Health Organization and the United Nations have embarked on transformative normative and financial reforms that could reimagine pandemic prevention, preparedness, and response (PPPR). These reforms include a new strategy to sustainably finance the WHO, a UN political declaration on PPPR, a fundamental revision to the International Health Regulations, and negotiation of a new, legally binding pandemic agreement (popularly called the “Pandemic Treaty”). We revisit the cavernous shortcomings of the global Covid-19 response, explain potentially transformative legal reforms and the ethical values that underpin them, and propose actionable solutions to advance both health and justice</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mass incarceration is an ethical crisis. Yet it is not only the magnitude of the system that is troubling. Mass incarceration has been created and sustained by racism, classism, and ableism, and the problems of the criminal legal system will not be solved without meaningfully intervening upon these forms of oppression. Beyond that, incarceration itself—whether of one person or 2 million—represents a moral failing. To punish and control, rather than invest in community and healing, is antithetical to the values of the field of bioethics. This commentary, which responds to the article “Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics,” by Sean Valles, considers abolition as a crucial form of justice that must be centered in the work of bioethics. Abolition is both an antiracist intervention and a means of considering the ways health care broadly and bioethics specifically have allowed for the perpetuation of carcerality in the United States.
大规模监禁是一场道德危机。然而,令人担忧的不仅仅是这一制度的规模。大规模监禁是由种族主义、阶级歧视和能力歧视造成和维持的,如果不对这些形式的压迫进行有意义的干预,刑事法律制度的问题将无法得到解决。除此之外,监禁本身--无论是一个人还是两百万人--都是道德上的失败。惩罚和控制,而不是投资于社区和治疗,是与生命伦理学领域的价值观背道而驰的。这篇评论是对肖恩-瓦莱斯(Sean Valles)的文章《美国大规模监禁五十年及其对生命伦理学的意义》(Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics)的回应,认为废除死刑是一种重要的正义形式,必须成为生命伦理学工作的中心。废除大规模监禁既是一种反种族主义的干预措施,也是一种考虑广义的医疗保健和具体的生命伦理学如何使美国的carcerality永久化的手段。
{"title":"The Problem Is Not (Merely) Mass Incarceration: Incarceration as a Bioethical Crisis and Abolition as a Moral Obligation","authors":"Jennifer Elyse James","doi":"10.1002/hast.1542","DOIUrl":"10.1002/hast.1542","url":null,"abstract":"<p><i>Mass incarceration is an ethical crisis. Yet it is not only the magnitude of the system that is troubling. Mass incarceration has been created and sustained by racism, classism, and ableism, and the problems of the criminal legal system will not be solved without meaningfully intervening upon these forms of oppression. Beyond that, incarceration itself—whether of one person or 2 million—represents a moral failing. To punish and control, rather than invest in community and healing, is antithetical to the values of the field of bioethics. This commentary, which responds to the article “Fifty Years of U.S. Mass Incarceration and What It Means for Bioethics,” by Sean Valles, considers abolition as a crucial form of justice that must be centered in the work of bioethics. Abolition is both an antiracist intervention and a means of considering the ways health care broadly and bioethics specifically have allowed for the perpetuation of carcerality in the United States</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well-understood in terms of what Bernard Williams calls “agent-regret.” We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience.
{"title":"Clinician Moral Distress: Toward an Ethics of Agent-Regret","authors":"Daniel T. Kim, Wayne Shelton, Megan K. Applewhite","doi":"10.1002/hast.1544","DOIUrl":"10.1002/hast.1544","url":null,"abstract":"<p><i>Moral distress names a widely discussed and concerning clinician experience. Yet the precise nature of the distress and the appropriate practical response to it remain unclear. Clinicians speak of their moral distress in terms of guilt, regret, anger, or other distressing emotions, and they often invoke them interchangeably. But these emotions are distinct, and they are not all equally fitting in the same circumstances. This indicates a problematic ambiguity in the moral distress concept that obscures its distinctiveness, its relevant circumstances, and how individual clinicians and the medical community should practically respond to it. We argue that, in a range of situations that are said to be morally distressing, the characteristic emotion can be well-understood in terms of what Bernard Williams calls “agent-regret.” We show what can thereby be gained in terms of a less ambiguous concept and a more adequate ethical response to this distinctive and complex clinician experience</i>.</p>","PeriodicalId":55073,"journal":{"name":"Hastings Center Report","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"哲学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}